To determine whether a weekly group exercise program plus home
exercises improves physical functioning or health status and prevents falls in
at-risk community-living older people

Men and women aged >65 years, >1 risk factor on
standardized assessment by general practitioner or

hospital‑based physiotherapist

N=163; 150 (92%) completing the trial included in falls
analysis

1 year

Intervention group: Supervised group exercise program (mean 9
per group) for 1 hour/week for 1 year (warm up then functional balance,
coordination, and strengthening exercises, fast walking, cool down, all to
music) with ancillary home exercises (based on class content) plus information
on strategies for avoiding falls

After adjusting for baseline covariates, the risk for multiple
falls in the tai chi group was 55% lower than that of the stretching control
group (risk ratio, 0.45; 95% CI, 0.30 to 0.70).

Compared with the stretching control participants, the tai chi
participants showed significant improvements (P <0.001) in all
measures of functional balance, physical performance, and reduced fear of
falling.

Intervention gains in these measures were maintained at a
6-month post-intervention follow-up in the tai chi group.

To investigate the impact of a 36-week individualized and
tailored group and home exercise intervention, compared with a control
intervention, in reducing falls and injuries in community-dwelling,
independent-living, frequent falling women aged 65+ years.

Women aged 65+ years, living in their own home without help,
with a history of 3 or more falls in the previous year

n=81

12 months

Intervention group: 36 weeks of Falls Management Exercise
(FaME) classes (balance specific) once a week for an hour. Followed Otago
Exercise Program at home (2/week, 30 minutes).

There was a 31% reduction in the number of falls during the
whole trial period for the exercise group compared with the control group from
negative binomial regression model 0.69; 95% CI, 0.50-0.96, P=0.029).
However, on further analysis, this reduction was totally due to the 54%
reduction in falls in the follow-up period (IRR 0.46; 95% CI,
0.34‑0.63).

The number of fallers among exercisers decreased progressively
from baseline through intervention to follow-up, while the number falling among
controls did not.

Falls were less frequent in the tai chi group than in the
control group. Using Cox regression and time to first fall, the hazard ratio
after 16 weeks was 0.72 (95% CI = 0.51-1.01, P=0.06), and after 24
weeks it was 0.67 (95% CI = 0.49-0.93, P=0.02).

No difference in the percentage of participants who had one or
more falls.

Statistically significant differences in changes in balance
favoring the tai chi group on five of six balance tests.

–

–

CI, confidence interval; IRR, incidence rate ratio;
SF-36, short form health survey with 36 questions
Adapted with permission
from Blackwell Publishing, 2007, Oxford, UK. Published in the book:
Evidence-Based Sports Medicine. From the chapter written by Robertson M and
Campbell A, (chapter 9) entitled: What type of exercise reduces falls in older
people?